Diagnostic Accuracy of TB-LAMP for Diagnosis of Pulmonary Tuberculosis among Adult Presumptive TB in Nigeria

Background: Microscopy is still used in resource-limited countries for PTB diagnosis because of the challenges associated with the GeneXpert instrument. For these settings, the WHO recommended the replacement of microscopy with TB-LAMP for PTB diagnosis in adults. Evidence supporting this recommendation shows a wide variation in quality and TB-LAMP diagnostic accuracy; thus, the need to validate the assay before its deployment in Nigeria. Methods: A cross-sectional study of 2636 consenting eligible adult presumptive TB from health facilities in two States of Nigeria. Sputum specimens were analyzed for PTB using TB-LAMP, Ziehl-Neelsen microscopy, Xpert, and solid culture (reference standard). Sensitivity and specificity of TB-LAMP, Xpert and smear microscopy for PTB diagnosis were determined. Results: Sensitivity and specificity of TB-LAMP for PTB diagnosis among all participants were 76.7% and 99.3% respectively (Youden Index [J] = 0.76). TB-LAMP’s PTB diagnostic accuracy was higher than microscopy (sensitivity = 54.3%, specificity = 99.8%, J = 0.54), but lower than Xpert (sensitivity = 84.5%, specificity = 99.1%). For HIV-seropositive participants, the diagnostic accuracy of TB-LAMP was similar to microscopy and Xpert (p > 0.05). Conclusion: TB-LAMP had high accuracy for adult PTB diagnosis in Nigeria, and it can replace microscopy for PTB diagnosis in adults. Read more
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Diagnostic Accuracy of TB-LAMP for Diagnosis of Pulmonary Tuberculosis among Adult Presumptive TB in Nigeria

Background: Microscopy is still used in resource-limited countries for PTB diagnosis because of the challenges associated with the GeneXpert instrument. For these settings, the WHO recommended the replacement of microscopy with TB-LAMP for PTB diagnosis in adults. Evidence supporting this recommendation shows a wide variation in quality and TB-LAMP diagnostic accuracy; thus, the need to validate the assay before its deployment in Nigeria. Methods: A cross-sectional study of 2636 consenting eligible adult presumptive TB from health facilities in two States of Nigeria. Sputum specimens were analyzed for PTB using TB-LAMP, Ziehl-Neelsen microscopy, Xpert, and solid culture (reference standard). Sensitivity and specificity of TB-LAMP, Xpert and smear microscopy for PTB diagnosis were determined. Results: Sensitivity and specificity of TB-LAMP for PTB diagnosis among all participants were 76.7% and 99.3% respectively (Youden Index [J] = 0.76). TB-LAMP’s PTB diagnostic accuracy was higher than microscopy (sensitivity = 54.3%, specificity = 99.8%, J = 0.54), but lower than Xpert (sensitivity = 84.5%, specificity = 99.1%). For HIV-seropositive participants, the diagnostic accuracy of TB-LAMP was similar to microscopy and Xpert (p > 0.05). Conclusion: TB-LAMP had high accuracy for adult PTB diagnosis in Nigeria, and it can replace microscopy for PTB diagnosis in adults. Read more
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Diagnostic Accuracy of TB-LAMP for Diagnosis of Pulmonary Tuberculosis among Adult Presumptive TB in Nigeria

Background: Microscopy is still used in resource-limited countries for PTB diagnosis because of the challenges associated with the GeneXpert instrument. For these settings, the WHO recommended the replacement of microscopy with TB-LAMP for PTB diagnosis in adults. Evidence supporting this recommendation shows a wide variation in quality and TB-LAMP diagnostic accuracy; thus, the need to validate the assay before its deployment in Nigeria. Methods: A cross-sectional study of 2636 consenting eligible adult presumptive TB from health facilities in two States of Nigeria. Sputum specimens were analyzed for PTB using TB-LAMP, Ziehl-Neelsen microscopy, Xpert, and solid culture (reference standard). Sensitivity and specificity of TB-LAMP, Xpert and smear microscopy for PTB diagnosis were determined. Results: Sensitivity and specificity of TB-LAMP for PTB diagnosis among all participants were 76.7% and 99.3% respectively (Youden Index [J] = 0.76). TB-LAMP’s PTB diagnostic accuracy was higher than microscopy (sensitivity = 54.3%, specificity = 99.8%, J = 0.54), but lower than Xpert (sensitivity = 84.5%, specificity = 99.1%). For HIV-seropositive participants, the diagnostic accuracy of TB-LAMP was similar to microscopy and Xpert (p > 0.05). Conclusion: TB-LAMP had high accuracy for adult PTB diagnosis in Nigeria, and it can replace microscopy for PTB diagnosis in adults. Read more
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Diagnostic Accuracy of TB-LAMP for Diagnosis of Pulmonary Tuberculosis among Adult Presumptive TB in Nigeria

Background: Microscopy is still used in resource-limited countries for PTB diagnosis because of the challenges associated with the GeneXpert instrument. For these settings, the WHO recommended the replacement of microscopy with TB-LAMP for PTB diagnosis in adults. Evidence supporting this recommendation shows a wide variation in quality and TB-LAMP diagnostic accuracy; thus, the need to validate the assay before its deployment in Nigeria. Methods: A cross-sectional study of 2636 consenting eligible adult presumptive TB from health facilities in two States of Nigeria. Sputum specimens were analyzed for PTB using TB-LAMP, Ziehl-Neelsen microscopy, Xpert, and solid culture (reference standard). Sensitivity and specificity of TB-LAMP, Xpert and smear microscopy for PTB diagnosis were determined. Results: Sensitivity and specificity of TB-LAMP for PTB diagnosis among all participants were 76.7% and 99.3% respectively (Youden Index [J] = 0.76). TB-LAMP’s PTB diagnostic accuracy was higher than microscopy (sensitivity = 54.3%, specificity = 99.8%, J = 0.54), but lower than Xpert (sensitivity = 84.5%, specificity = 99.1%). For HIV-seropositive participants, the diagnostic accuracy of TB-LAMP was similar to microscopy and Xpert (p > 0.05). Conclusion: TB-LAMP had high accuracy for adult PTB diagnosis in Nigeria, and it can replace microscopy for PTB diagnosis in adults. Read more
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